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    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.


    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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Larviciding raises questions

The growing popularity of larviciding as a malaria control mechanism in Africa has caused stakeholders to demand that the intervention being sponsored by the Cuban government is properly administered for the benefit of people at risk of the disease.

Cuban larvicide interest in Kenya began in January 2009, following the formation of a Joint Commission between the two countries.

Larviciding is a technology that involves the use of naturally occurring bacteria, which releases a toxin that is digested by the mosquito larvae, leading to their destruction.
Larva is one of the four stages in a mosquito’s life cycle. Larviciding is a source reduction of mosquitoes seen as an efficient and ecologically safe approach.  It involves applying pesticides to breeding habitats to kill the larvae.

Larviciding may include the simple technique of adding surface films to standing water to suffocate mosquito larvae.  

The most common form of source reduction is dumping out containers around the home that create a habitat for mosquitoes to lay their eggs.

These larvicides will last only a few weeks in water and pose no danger to humans, non-targeted animal species or the environment, when used according to directions.

During the larval stage the pests are often concentrated within defined water boundaries, immobile with little ability to disperse. Adult mosquitoes, in contrast, fly in search of mates, blood meals, or water sources for egg laying and are often inaccessible, not concentrated and widely distributed.  

Mosquitoes breed in standing water. Without it they cannot continue their life cycle. Therefore, effective larviciding can reduce the number of mosquitoes which spread disease, create a nuisance, and lay eggs to breed even more mosquitoes.

The new approach is raising concerns as many questions remain unanswered. First, there is very little evidence of its impact as a control mechanism and also its effect on vegetation and humans.
The approach may require detailed entomological surveillance and skills to be implemented properly.  There are also fears it may not be cost effective and is likely to be effective only in places where breeding sites are few, fixed, and available.

New guidelines being developed by the World Health Organization (WHO) criticize the effectiveness of larviciding, when employed as the main malaria intervention strategy in Africa.
The UN body has raised reservations as to whether the mosquito larvicide products manufactured by Labiofam are effective in the first place.

Another issue of concern was the report in The Financial Times that the Ghanaian government had to pay a whopping $74 million to Labiofarm in a span of two years for a single larviciding programme.

The WHO appears unconvinced about the effectiveness of Labiofam’s products. It is equally concerned that the increasing Cuban larvicide sales in Africa, was diverting funds from other effective methods of fighting malaria.

In spite of the controversies, larval control as a supplementary approach to fighting malaria seems to be gaining grounds.  A Tripartite Agreement was signed recently between the Economic Community of West African States (ECOWAS), Cuba and Venezuela for such an endeavour.

The construction of bio-larvicide factories in Ghana, Nigeria and Cote d’Ivoire, is set to greatly strengthen the fight against malaria in the West African region.

Labiofarm’s larvicide product known as Griselesf is widely used in many African countries, including Ghana, Nigeria, Tanzania, Angola, Burkina Faso, Zambia and Equatorial Guinea.

In the East African nation of Kenya the technology is known to have been used in Kisii and Suba Districts in western regions of the country as well as in Malindi at the coast.
Scientists say these products have a specific and limited role in controlling the spread of malaria.  In addition, the products can only be used in areas where mosquito breeding sites are few, fixed and can be found, which is not the case in Africa.
The new factory in Nigeria is expected to supply larvicide products to boost vector control, thereby leading to the elimination of malaria in the region by the targeted date of 2015.

West Africa has the heaviest malaria burden on the continent, where a child dies every 30 seconds from the disease, a primary cause of illness and death among children and pregnant women.  

According to the story in the UK’s Financial Times, health experts are concerned that the use of these products is not the most cost-effective method to fight malaria.

The President of the ECOWAS Commission, Ambassador Kadre Desire Ouedraogo says an integrated approach against malaria was the way to go.

“The goal of malaria elimination in the ECOWAS region is achievable, through the strengthening of the vector control component of an integrated strategy under a Tripartite Agreement,” says the President.

WHO recommends that larviciding should be used only for vectors which tend to breed in permanent or semi-permanent water bodies that can be identified and treated.

This is done where the density of the human population to be protected is sufficiently high to justify the treatment with relatively short cycles of all breeding places.

It also states that detailed knowledge of the local vectors is required and that larval control cannot be applied everywhere. But this does not mean that larval control is not a good weapon to be added to the toolbox.

With the knowledge that indoor interventions alone may not bring elimination, it stands to reason that practical larviciding is encouraged to enhance the fight against malaria.

Some say there is yet too little evidence from Africa to make a strong case for larviciding, adding that it may not be cost-effective, particularly in rural areas, because it requires detailed entomological surveillance and skills to be implemented properly.

According to Julio Caesar Gonzalez Marchante, a former Cuban ambassador to Kenya, larviciding helped to eradicate malaria from the island over three decades ago.

“Cuba began developing the technology after the Second World War, which greatly helped the country eliminate the disease” said Gonzalez.

He adds that the interest shown by Cuba in helping Africa fight malaria, has everything to do with the socio-cultural ties shared between the continent and the communist island nation.
But when asked about the progress of this joint venture between Kenya and Cuba, Dr John Logedi, the deputy head of the Division of Malaria Control (DOMC) in Kenya, says that the programme is still in its infancy.
“The programme has not taken off yet because we are still mobilizing for funds,” he said.
Edward Mwangi, the chief executive of the Kenya NGO’s Alliance Against Malaria (KeNAAM) says that no single intervention is effective, on its own against the disease.

“It has been shown that the best way of tackling malaria on the continent was the use of a combination of strategies, such as insecticide-treated nets, indoor residual spraying, drugs and diagnostics,” he says.

- By Geoffrey Kamadi - Kenya

Tenth Edition